Long-term care includes nursing homes (also called long-term care nursing facilities), residential care communities, post-acute care, home health care, and adult day care services. Long-term care can also include assisted living and personal care homes. The Pennsylvania Department of Health enacts different regulations for each type of care facility.

In Pennsylvania, the highest level of care is required in a “long-term care nursing facility,” often what we understand to be a nursing home. Such facilities must meet state and federal regulations. These are considered medical facilities, and they are inspected and licensed by the Pennsylvania Department of Health. Such facilities have third-party Medicare and Medicaid reimbursement for those who qualify.

Personal care homes are also residential facilities, offering personal care services, assistance, and supervision to four or more people. These types of facilities, sometimes also called assisted living, retirement, or boarding homes, provide a lesser degree of care. They are inspected and licensed to operate in Pennsylvania and are subject to certain state regulations. This type of facility does not have third-party reimbursement under Medicare but may accept low-income residents receiving Supplemental Security Income (SSI).

One of the most important things is to research the organization or facility which may provide the care. There are two websites that can give you a lot of information to get started evaluating nursing homes. Medicare has a website at Medicare.gov/Nursing Home Compare, which is a great resource to help understand the questions to ask, and how a nursing home stacks up against its competitors. It includes information on health and safety inspections and gives star ratings for each facility. Pennsylvania’s Department of Health has a website at Health.pa.gov/Nursing Home Locator, where you can locate facilities in your area, and review surveys and discussions of deficiencies and corrections at these facilities.

Visiting the nursing home or other facility, and talking to the staff, will also give you a feel for the structure, programs, and staffing. You should make sure to ask all of the questions you have and get full answers to them. You may want to visit the facility, talk to therapy or other departments who would be involved in your loved one’s care, or even speak to other families who have had loved ones with the same facility.

Additionally, if you or your loved one is being discharged from the hospital and needs to go to a long-term care facility, the hospital’s social worker will be able to provide you with some basic information on available nursing homes in your area and the types of services they provide.

The signs of abuse and neglect may be very obvious or sometimes more subtle. Here are some potential signs of nursing home or long-term care neglect and abuse:

• Cuts and bruising
• Bedsores
• Broken bones
• Falls
• Unexplained weight loss
• Change in mental status
• Medication errors
• Dehydration
• Refusal to speak, eat or take medications

The key is to follow your gut and common sense. If something does not seem right, speak up, ask about it and make sure you get a response with which you are comfortable.

If you have concerns about a loved one’s care or condition that are not addressed by the facility to your satisfaction, you can ask to speak to a charge nurse, supervisor, director of nursing, facility administrator, or attending doctor.

Our attorneys at Cohen, Feeley, Altemose & Rambo are experienced in investigating the care, injuries, and liability of the long-term care facility and our initial consultation is always free.

You can report suspected neglect or abuse to the Pennsylvania Department of Health, telephone 1-800-254-5164. You can also use their online complaint form and email it to c-ncomplai@pa.gov; or you can send a complaint by mail or fax to: Division of Nursing Care Facilities Director, Pennsylvania Department of Health, Division of Nursing Care Facilities, 625 Forster St., Room 526, Health and Welfare Building, Harrisburg, PA 17120-0701/fax 717-772-2163.

You can also contact the Statewide Elder Abuse Hotline at 1-800-490-8505 or the local Area Agency on Aging (which has a locator at Aging.pa.gov) to make a complaint.

Make an informed choice. Look at the websites at Medicare.gov/Nursing Home Compare and Health.pa.gov/Nursing Home Locator. Social workers can be a good resource if you are coming from another facility to let you know what is available and where they are located. Visit the facilities, speak not only to the admissions staff but those who would provide different services such as therapy, nursing, etc. Observe the physical layout, the rooms, the staff, and interactions with other residents while you are there. Make a list of questions and make sure you get your answers. Speaking to other families who have had loved ones at the same facility is very important. Also, picking a facility close to family members and activities is a great way to make sure you can visit as often as possible.

Initially, it can be hard to determine if an injury to a loved one is a result of abuse or neglect. For instance, extensive bruising can occur due to blood thinners with no great trauma. Conditions or injuries may occur that are not the fault of the facility. On the other hand, millions of older Americans fall victim to some form of neglect or abuse every year, and many more cases go unreported, with serious injuries resulting.

The key is to follow your gut and common sense. If something does not seem right, speak up, ask about it and make sure you get a response with which you are comfortable. If you suspect your loved one has suffered neglect or abuse, or your concerns are not addressed by the facility to your satisfaction, you can ask to speak to a charge nurse, supervisor, director of nursing, attending doctor, or the facility administrator.

Our attorneys at Cohen, Feeley, Altemose & Rambo are experienced in investigating the care, injuries, and liability of the long-term care facility and our initial consultation is always free.